Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MARDELL JACKSON
Active Sole ProprietorMARDELL JACKSON is a Assisted Living Facility healthcare provider located in LAKE CITY, Florida. NPI 1598247009 is currently active in the NPPES registry. Verify at CMS.
Assisted Living Facility · LAKE CITY, FL
Registration Details
- NPI Number
- 1598247009
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 30, 2018 (7.9387572240254 yrs)
- Last Updated
- Aug 30, 2018
- Sole Proprietor
- Yes
Practice Information
- Address
-
197 NW GWEN LAKE AVELAKE CITY, FL, 320553711Browse FL providers · Browse ZIP 32055
- Phone
- 3866979425
- Primary Specialty
-
Assisted Living Facility
310400000X
Other Assisted Living Facility Providers in LAKE CITY, FL
| Name | Credential | NPI |
|---|---|---|
| CLARA FERGUSON I | — | 1366866097 |
| JANICE SUMMERS | — | 1972904381 |
| SHENAY FULTON | — | 1235745753 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.